Ligature-tier



E. C. WOOD LIGATURE-TIER May 8, 1962 3 Sheets-Sheet 1 Filed May 5, 1958INVENTOR. fines C. W d,

May 8, 1962 E. c. WOOD 3,033,204

LIGATURE-TIER Filed May 5, 1958 5 Sheets-Sheet 2 INVENTOR.

May 8, 1962 E. c. WOOD 3,033,204

LIGATURE-TIER Filed May 5, 1958 3 Sheets-Sheet 3 Era 15 72f} 42%4 6.6

INVENTOR.

I Lrvzesi C. 146 4 3,333,204 Patented May 8, 1962 3,033,204LlGATURE-TIER Ernest C. Wood, 6363 Wilshire Blvd, Los Angeles, Calif.,

assignor of thirty percent to Adolph M. Brown, Beverly Hills, and thirtypercent to Rene G. Le Vaux, Los

Angeles, Calif.

Filed May 5, 1958, Ser. No. 732,877 13 Claims. (Cl. 128-326) Thisinvention relates to an instrument for stopping arterial or venousbleeding during surgical procedures.

Bleeding blood vessels are often encountered during surgical procedures,and the success of an operation is often dependent on the speed withwhich the bleeding can be stopped. Heretofore, when such bleeding bloodvessels were encountered, they first had to be clamped with a hemostat.Then a piece of catgut, silk or cotton string had to be tied around thecircumference of the blood vessel with two or three square knots. Next,the hemostat or clamp was removed, and finally the loose ends of theknot were cut away from the tied end of the blood vessels. These steps,which were performed manually, were time consuming, and when manybleeding blood vessels were encountered the time required to tie each ofthem was often of critical importance.

In addition, these manual procedures occupied both hands of the surgeon.This left the surgeon incapable of doing other essential work in thislife-saving operation. This created severe and sometimes insurmountabledifiiculties, especially when the blood vessel was located in a tinyspace. Furthermore, during surgical procedures, it is oftentimesdesirable and sometimes necessary to employ one hand for certainpurposes while attempting to control the bleeding. Thus, the assistanceof a considerable staff of trained personnel was required foroperations, and the increased numbers of hands often led to confusionand interferences in the operation.

What is needed, therefore, and comprises the principal object of thisinvention, is an instrument which operates simply and efficiently toclamp and tie a bleeding blood vessel.

A further object of this invention is to provide an instrument forclamping and tying a blood vessel with a ligature, and for cutting theloose ends of the ligature away from the blood vessel.

Still a further object of this invention is to provide an instrumentwhich can be conveniently operated by one hand for clamping a bleedingblood vessel, tying it with a ligature, and cutting oif the ends of theligature knot.

Yet another object of this invention is to provide an instrument whichcan be used in small confining space for clamping and tying a bloodvessel, and for cutting d the ends of a ligature used to tie the bloodvessel.

These and other objects of this invention will become more apparent whenread in the light of the accompanying drawings and specificationWherein- FIGURE 1 is a side elevational view of the combined hemostatand ligature tier;

FIGURE 2 is a plan view of the instrument shown in FIGURE 1;

FIGURE 3 is a rear elevational view of the combined hemostat andligature tier;

FIGURE 4 is a sectional view taken on the line 44 of FIGURE 1 andlooking in the direction indicated;

FIGURE 5 is a sectional view taken on the line 5--5 of FIGURE 1 andlooking in the direction indicated;

FIGURE 6 is a side elevational view of a portion of the combinedhemostat and ligature tier for showing the surface of a jaw opposite tothe one shown in FIGURE 1;

FIGURES 7, 8, and 9 show sequential steps in the manipulation of thecombined hemostat and ligature tier;

FIGURES 10 and 11 show enlarged sequential details of the operation ofparts of the combined hemostat and ligature tier when tying off ableeding blood vessel;

FIGURE 12 is a top view of the portion of the instrument disclosed inFIGURE 10;

FIGURE 13 is a sectional view taken on the line 1313 of FIGURE 11 andlooking in the direction indicated; and

FIGURE 14 is a view of the ligature used in connection with the combinedhemostat and ligature tier.

Referring now to FIGURE 1 of the drawing, the combined hemostat andligature tier indicated generally by the reference numeral 10 comprisesa main support bar 12. This support bar happens to be substantiallyrectangular in cross-section, although other shapes may also prove to beuseful. A pistol grip 14 is rigidly connected to one end of the supportby means of screws 15, and a fixed jaw 16 is integrally formed on theopposite end thereof and at a slight angle thereto.

A movable jaw 18 is pivotally connected to support 12 on pivot 20, andis disposed in cooperative engagement with the fixed jaw 16, so theyform a pair of clamp jaws for holding a blood vessel therebetween. Asseen, these clamp jaws are disposed at an angle to the support bar 12.This angular relationship is not essential, but it is useful because itmakes the instrument easier to manipulate. An actuating arm 22 isintegral with the movable jaw 18, and extends toward the pistol grip 14,terminating in a thumb-actuated lever 24 adjacent thereto and preferablyspaced above the rearward end of the support bar 12.

A carriage, indicated generally by the reference numeral 26, comprisesspaced parallel side walls 28, and top and bottom walls 30 and 31,respectively, see FIG- URES 2 and 6. The carriage walls, held togetherby screws 29, are arranged so they define a longitudinal opening 32,substantially rectangular in cross-section, through which the support 12extends. The size of the opening 32 is such that its inner surfaces arein sliding engagement with the external surfaces of the support 12, seeFIGURES 2 and 5. This arrangement permits the carriage 26 to move alongthe support 12, but because of the non-circular cross-sectional shape ofthe support, the carriage 26 cannot rotate on it.

As seen in FIGURES 1 and 6, the side walls 28 of the carriage 26 projectbelow the support bar 12 and are joined together to form adependingtrigger-shaped member 34. With this arrangement, when theinstrument 10 is held in the hand of an operator by the pistol grip 14,a finger, usually the trigger finger of the same hand can be used tosqueeze the trigger-shaped member 34 and thereby move the carriage 26toward the pistol grip 14, see FIGURES 7, 8, and 9.

A leaf spring 33 is rigidly secured to the bottom wall 31 of carriage 26by means of a screw 36. This spring extends toward jaw 18 and is biasedinto engagement with it for purposes to become apparent below. The topwall 30 of carriage 26 extends toward jaw 16 and terminates in a hook38, see FIGURES 6 and 10. With this arrangement, it is apparent that thehook member 38 and the leaf spring 36 must move with the carriage 26.

The top surface 4% of support 12 is provided with a longitudinallyextending T-shaped groove or guide path 42, see FIGURE 13. A flexibleblade 44, substantially equal in length to the support 12, is slidablymounted in groove 42, see FIGURES 2 and 10. A cutting edge 46 is formedon one end of the blade 44, see FIGURES 10 and 11, and the opposite end48 of this blade projects out beyond the end of groove 42 adjacent thepistol grip 14, see FIGURE 1. A first leaf spring 50 is mounted on thepistol grip 14 by means of a screw 52. This leaf spring is interlockedwith the end 48 of blade 44 by any convena a tional means, see FIGURE 4,and acts to bias the blade 44 in the direction of the pistol grip 14. Asecond leaf spring 54 is also mounted on the pistol grip 14 by the screw52, see FIGURE 3. As seen in FIGURE 1, one surface of this leaf spring54 abuts against the end portion 48 of blade 44, and this leaf spring isshaped to be actuated by thumb pressure when the instrument is held bythe pistol grip in the hand of the operator, see FIGURE 9. It isapparent that when thumb pressure is exerted on the leaf spring 54, theblade 44 is moved toward the jaws 16 and 18 and into a cutting position.When the pressure on leaf spring 54 is removed, it returns to its restposition and the tension in the first leaf spring 50 caused by thedisplacement of the blade 44 automatically retracts the blade from itsadvanced cutting position on support 12'.

A lock member 56, conventional in operation, is in tegral with thepistol grip 14 and projects upwardly therefrom terminating above theupper surface 40 of the support 12, see FIGURES 1 and 3. This lockmember is designed to engage the actuating arm 22 of jaw 18 andreleasably holds the jaws 16 and 18 in a clamping position for reasonsto be described below, see FIGURES 8 and 9.

The ligature shown in FIGURE 14 and designed to be used with theinstrument 10, is indicated generally by the reference numeral 60. Asseen, it comprises a piece of string-like material and is usually formedfrom catgut, silk, or cotton. A slip knot 62 is tied in the ligature,forming an adjustable loop 64 at one end thereof. It is apparent,however, that other means for forming this adjustable loop may be usedand are contemplated. A fixed loop 66 is also formed in the ligature bymeans of a knot 68 and is connected to the adjustable loop 64 by meansof a connecting portion 70. Here also, the fixed loop in the ligaturecould be formed by other means than by tying a knot. The connectionbetween portion 70 and the adjustable loop 64 is such that if theadjustable loop is surrounding a blood vessel, then a pulling forceexerted on portion 70 will decrease the size of the adjustable loop 64and cause it tightly to embrace the blood vessel to prevent it frombleeding, see FIGURE 11.

The ligature 60 is mounted on the device 10 in such a way that operationof the device causes the ligature 60 to tie a blood vessel. Thisrequires the adjustable loop portion 64 of the ligature 60 to beinitially positioned on sup port 12 so that it loosely embraces the jawclamps 16 and 18 and with a portion of loop 64 disposed in a locatinggroove 72 formed in jaw clamp 18, see FIGURE 10. This part of loop 64 isheld in this locating groove by the leaf spring 33 secured to thecarriage 26, when the carriage is stationary and in a predeterminedposition on support 12. This arrangement keeps the loop 64 properlyplaced for effective operation of the instrument. The required positionfor carriage 26 can be conveniently determined by means of a positioningrecess 37 formed in jaw 18. A detent 35 is located on the leaf spring 33in such a way that it is biased into the positioning recess 37 only whenthe carriage is in this predetermined position. As seen, recess 37 isprovided with a cam surface 39, so that when the carriage 26 is movedtoward the pistol grip 14, the detent 35 will ride up on this camsurface and move the leaf spring 33 out of engagement with jaw 18 andconsequently free the adjustable loop 64 and permit it to leave thelocating groove 72. This movement is indicated by the dotted lines shownin FIGURE 11. Since the fixed loop 66 is also in engagement with thebook 38 on the carriage 26, the same movement of carriage 26 toward thepistol grip 14 will carry the hook 38 along with it, and this will causea pulling force to be exerted on portion 70 of the ligature 60.

When a pulling force is exerted on portion 70 of the ligature 60, theadjustable loop 64 is designed to decrease in size. The upwardinclination of the clamped jaws 16 and 18 and the decreasing dimensionof the jaws, coupled with the pulling force exerted by the portion 70,causes the loop to be displaced outwardly toward the ends of theclamping jaws until it is slipped off the end into engagement with theblood vessel beyond the portion clamped between the jaws. As the pull iscontinued, it tightly embraces the blood vessel to stop it frombleeding.

Initially, the adjustable loop 64 surrounds the jaw clamps 16 and 18 butnot the blood vessel 65. Consequently, one of the functions of theinstrument must be to move the adjustable loop 64 off the jaws 16 and 18and around the periphery of the blood vessel 65. Since the pulling forceon the ligature caused by the movement of the carriage 26 toward thepistol grip 14 is along the same direction, means must be provided tomove the adjustable loop 64 in an opposite direction so it can move offthe end of the support 12. To assist in this movement, an opening 74 isformed in jaw 16, see FIGURE 6. This opening begins at the extreme end19 of jaw 16 and extends only partially through the jaw (half waythrough has been found to be practical), see FIGURE 10. This is madeevident by a comparison of the opposite surfaces of jaw 16 in FIGURES 1and 6. As seen, opening 74 extends toward the rear of jaw 16 andinclines upwardly toward its top surface 17.

With this structure, and with the adjustable loop 64 surrounding thejaws 16 and 18, as shown in FIGURE 10, the connecting portion 70 of theligature 60 may conveniently extend from the slip knot 62 toward theextreme end 19 of jaw 16. From there, the connecting portion 70 maypenetrate opening 74 and follow this opening back toward the rear uppersurface 17 of the jaw 16. From there portion 70 may pass through theadjustable loop 64 and terminate in the connection between the fixedloop 66 with the hook member 38, see FIGURE 12. In this way, when apulling force is exerted on the fixed loop 66 by the movement of thecarriage 26 toward the pistol grip 14, the connecting portion 70, whichis looped around the end 19 of the jaw 16, will pull the slip knot 62and the adjustable loop 64 toward this free end and cause it to move offthe jaws 16 and 18, see FIGURES 10 and 11. If this happens while thejaws are in a clamping position on a blood vessel, as shown in FIGURE11, then this movement of the carriage will cause the adjustable loop 64of the ligature 60 to move off the jaws of the instrument and surroundthe external surface of the blood vessel. Any further increase in themovement of the carriage 26 toward the pistol grip 14 will thereforecause the adjustable loop 64 to tighten around the blood vessel and stopit from bleeding.

It is noted that one of the functions of the clamping jaws 16 aind 18 isto hold the blood vessel 65 in a fixed position and to absorb the straincaused by tightening the loop 64. This is necessary to prevent thepulling force exerted on the connecting portion 70 of the ligature frombeing exerted directly on the blood vessel 65. Without this arrangement,the pulling force on portion 70 of the ligature which is necessary totighten the loop 64 around the blood vessel, might be sufiicient to ripor completely tear away large portions of this blood vessel.

Once the adjustable loop 64 of the slipknot 62 is tightened around theblood vessel 65, as shown in FIG- URE 11, the ends of the knot must becut away. As shown in FIGURES l0 and 11, the opening 74 is formed so itintersects the T-shaped groove or guide path 42 in which the blade 44 isslidably mounted. The cutting edge 46 of this blade 44, when in aretracted or non-cutting position, is comparatively near theintersection of groove 42 and opening 74, so that when portions of theligature 60 are in opening 74, as shown, only a slight forward motion ofthe cutting edge 46 is necessary to cut through the connecting part 70of the ligature adjacent the slip knot 62, see FIGURE 11. Furthermore,in this embodiment, only one end of the slip knot 62 has to be outbecause the slip knot is either formed so that the opposite end of theknot is initially short enough, or else this opposite end is cut beforethe ligature is mounted on the mstrument.

The blade 44 is flexible to permit it to conform to the arcuate portion41 of the path 42 caused by the inclined angular relationship betweenthe support 12 and the jaws 16 and 18. To keep the blade sliding againstthe bottom of the arcuate portion 41 of the guide path 42 so it can cutthe ligature 60, a fixed pin 43, see FIGURE 11, is rigidly connected tothe sides of the groove or guide path 42 by any convenient means. Thisarrangement prevents the blade 44 from leaving the arcuate portion 41 ofthe groove or guide path 42 as it is moved forwardly by pressure on leafspring 54, as described above.

In operation, the instrument with the ligature 60 secured thereon asshown in FIGURE 10, is held in the hand 80 of the operator by the pistolgrip 14, see FIG- URE 7. Next, the thumb 82 of the hand 80 holding theinstrument engages the thumb-actuated lever 24 and pivots the connectedactuating arm 22 so that the jaws 16 and 18 separate far enough toreceive a blood vessel 65, see FIGURE 10. Next, the thumb 82 is used toagain pivot the actuating arm 22 and clamp the jaws 16 and 18 togetherwith the blood vessel 65 between them. To this point, the clamp jaws areacting as a temporary hemostat. Next, the actuating arm 22 is hookedunder the lock member 56 to keep the clamping jaws 16 and 18 togetherwithout further thumb pressure, see FIGURE 8. Then a finger, usually thetrigger finger 84 of the hand 80, encircles the trigger-shaped member 34and exerts a pressure on it. This pressure'moves the carriage 26 towardthe pistol grip 14 and, as described above, moves the adjustable loop 64off the jaws 16 and 18 and over the outer surfaces of the blood vessel65. Further movement of the carriage 26 toward the pistol grip tightensthe loop 64 around the blood vessel and stops any bleeding, see FIGURES9 and 11.

Then the thumb 82, freed from the necessity of holding the clamping jaws16 and 18 in a clamping position, presses against the thumb-actuatedleaf spring 54 and forces the blade 44 forward into cutting engagementwith the ligature, as shown in FIGURE 11. This severs the ligature nearthe slipknot 62 and cuts the connection between the instrument 10 andthe blood vessel 65, permitting the instrument to be removed and leavingthe blood vessel securely tied.

It is apparent that through the use of this instrument blood vessels'canbe tied off conveniently and quickly. Furthermore, only one hand isrequired to operate the instrument, leaving the other hand of thesurgeon free to perform other operating procedures. Furthermore, sincethe clamping jaws 16 and 18- are small and narrow, the instrument can beusefully employed in tying off bleeding blood vessels which are locatedin confined, heretofore inaccessible, locations.

The invention may be embodied in other forms without departing from thespirit or essential characteristics thereof as set forth in the claims,and the present embodiment is therefore to be considered as illustrativeand not re-' strictive, and it is intended to include all changes whichcome within the scope and range of the claims.

I claim:

1. An apparatus of the class described comprising a support having alocating groove therein for initially positioning a ligature, a carriagemovably mounted on said support, first means connected to said carriagefor holdingsaid ligature within said groove on said support when saidcarriage is in a predetermined stationary position, and second meansconnected to said carriage and adapted to be connected to said ligaturefor moving it out of said groove and along said support when saidcarriage is moved in one direction, means mounted on one end of saidsupport and adapted to be connected to a ligature mounted on saidsupport in such a way that when said carriage and said first and secondmeans are moved. in one direction along said support, at least a portionof said ligature is moved in the opposite direction along said support.

determined portions of any ligature mounted on said.

support.

3. An apparatus for tying a ligature to a blood vessel comprising asupport, a pistol grip rigidly connected to said support, a carriagemovably mounted on said support, a first means connected to saidcarriage and adapted to hold a ligature in a desired position on saidsupport when said carriage is in a predetermined stationary position, asecond means connected to said carriage and adapted to be connected tosaid ligature for moving it along said support when said carriage ismoved toward said pistol grip, means mounted on said support in spacedrelation to the pistol grip and adapted to be connected to a ligaturemounted on said support so that when said carriage and said first andsecond means are moved toward said pistol grip, at least a portion ofsaid ligature is moved in the opposite direction along said support andinto a tying position around said blood vessel, a triggershaped memberrigidly connected to and depending from said carriage so that when theapparatus is held in the hand of an operator by the pistol grip a fingerof the same hand can be used to squeeze the trigger-shaped member andmove the carriage along said support toward the pistol grip whereby'aligature can be tied around a blood vessel using only one hand.

4. The apparatus set forth in claim 3 including a guide track formed insaid support, a cutting blade movably mounted in said guide track, andmeans for moving said cutting blade along said guide track into cuttingengage-- ment with any ligature mounted on said support.

5. An apparatus for tying a ligature to a blood vessel comprising asupport, a pistol grip rigidly connected to ,said support adjacent oneend, a fixed jaw formed on the opposite end thereof, a movable jawpivotally mounted on said support and positioned opposite said fixed jawto form a pair of jaw clamps adapted to hold a blood vesseltherebetween, an actuating rod rigidly connected to said movable jaw andextending toward said pistol grip for manipulation of said jaw clamps, acarriage movably mounted on said support, a first means connected tosaid carriage for holding a ligature in a desired position on saidsupport when said carriage is in a predetermined stationary position, asecond means connected to said carriage and adapted to be connected tosaid ligature for moving it along said support when said carriage ismoved toward said pistol grip, means mounted on one of said jaws andadapted to be connected to a ligature mounted on said support so thatwhen said carriage and said first and second means are moved toward saidpistol grip, at least a portion of said ligature is moved in theopposite direction along said support and into a tying position aroundsaid blood vessel, a trigger-shaped member rigidly connected to anddepending from said carriage so that when the apparatus is held in thehand of an operator by the pistol grip, a finger of the same hand can beused to squeeze the trigger-shaped member and'move the carriage alongsaid support toward the pistol grip, whereby a ligature can be tiedaround a blood vessel using only one hand, a guide track formed in saidsupport, a. cutting -blade movably mounted in said guide track, andmeans for moving said cutting blade along said guide track into cuttingengagement with a ligature mounted on said support. I

6. An apparatus for tying a ligature to a blood vessel comprising incombination a support, a pistol grip rigidly connected to one endof'said support, a fixed jaw formed on the opposite end thereof, amovable jaw pivotally mounted on said support and positioned oppositesaid fixed jaw to form a pair of jaw clamps for holding a blood vesseltherebetween, an actuating arm rigidly con nected to said movable jawand extending toward and terminating near said pistol grip forconvenient manipulation of said jaw clamps, a carriage movably mountedon said support, a leaf spring connected to said carriage and biasedagainst one of said jaw clamps, a ligature made from a string-likematerial with a slip knot formed thereon, the loop of said slip knotloosely embracing said jaw clamps and a portion thereof held against oneof said jaw clamps by said leaf spring, a hook member connected to saidcarriage, said hook member connected to a portion of said ligature,means mounted on the free end of one of said jaw clamps and connected toa portion of said ligature so that when said carriage and the connectedleaf spring and hook member are moved toward said pistol grip the loopof said slip knot is freed from its engagement with one of said jawclamps and moves off the free end of the jaw clamps and around any bloodvessel held between them, the connection between said hook member andsaid ligature exerting a force on said slip knot so that continuedmovement of said carriage toward said pistol grip tightens the looparound said blood vessel, a trigger-shaped member rigidly connected toand depending from said carriage so that when the apparatus is held inthe hand of an operator a finger of the same hand can be used to squeezethe trigger-shaped member and move the carriage toward the pistol gripwhereby the slip knot of the ligature can be tightened around a bloodvessel using only one hand, a guide track formed in said support andterminating near the end of said rigidly attached jaw clamp, a cuttingblade movably mounted in said guide track, and means mounted on saidpistol grip for moving said cutting blade along said guide track andinto cutting engagement with the ligature to cut off the ends of theknot around the blood vessel.

7. An apparatus of the class described for use with a ligature having alooped end portion and a free end portion which operates to tighten theloop during relative endwise displacement of the free end portion in thedirection away from the loop, comprising a support formed of a pair ofelongate arms pivoted one on the other intermediate their ends toprovide a clamping portion at the forward end and a handle portion atthe rearward end for rocking movement of the arms about the pivotbetween open and clamping positions with the vessel to be tied grippedbetween the portions of the arm forming the clamping end portion when inclamped position, carriage means mounted on said support for lengthwisemovement relative to the support between a forward position rearwardlyof the clamping end portion of the support and to one side thereof and arearward position toward the handle portion of the support, the supportin the clamping end portion being formed with smooth and unobstructedsurfaces on the side adjacent to the carriage and in which the clampingend portion of the arm adjacent the carriage is formed with a passageextending therethrough from the forward edge to a point on the side ofthe carriage and spaced rearwardly of the end but forwardly of thecarriage when in the forward position, means on the carriage forreleasably engaging the free end portion of the ligature when the loopedend portion of the ligature is positioned about the end portion of thesupport and the free end portion of the ligature is threaded through thepassage from the forward end to the rearward end releasably to beengaged by the carriage when in forward position whereby rearwarddisplacement of the carriage from forward position toward rearwardposition operates to effect forward displacement of the looped endportion for travel off of the clamping end portion of the support andabout the vessel being clamped.

8. An apparatus as claimed in claim 7 in which the clamping end portionis angled slightly from the remainder of the support in the directiontowards the carriage.

9. An apparatus of the class described for use with a ligature having alooped end portion and a free end portion which operates to tighten theloop during relative endwise displacement of the free end position inthe direction away from the loop, comprising a support formed of a pairof elongate arms pivoted one on the other intermediate their ends toprovide a clamping portion at the forward end and a handle portion atthe rearward end for rocking movement of the arms about the pivotbetween open and clamping positions with the vessel to be tied grippedbetween the portions of the arm forming the clamping end portion when inclamping position, carriage means mounted on said supported forlengthwise movement relative to the support between a forward positionrearwardly of the clamping end portion of the support and to one sidethereof and a rearward position toward the handle portion of thesupport, the support in the clamping end portion being formed withsmooth and unobstructed surfaces on the side adjacent to the carriageand in which the clamping end portion of the arm adjacent the carriageis formed with a passage extending therethrough from the forward edge toa point on the side of the carriage and spaced rearwardly of the end butforwardly of the carriage when in the forward position, means on thecarriage for releasably engaging the free end portion of the ligaturewhen the looped end portion of the ligature is positioned about the endportion of the support and the free end portion of the ligature isthreaded through the passage from the forward end to the rearward endreleasably to be engaged by the carriage when in forward positionwhereby rearward displacement of the carriage from forward positiontoward rearward position operates to effect forward displacement of thelooped end portion for travel off of the clamping end portion of thesupport and about the vessel being clamped and whereafter continuedrearward movement of the carriage towards rearward position operates totighten the loop about the clamped vessel for strangulation.

10. An apparatus as claimed in claim 7 in which the means on thecarriage releasably to engage the free end portion of the ligaturecomprises a hook member.

11. An apparatus of the class described for use with a ligature having alooped end portion and a free end portion which operates to tighten theloop during relative endwise displacement of the free end portion in thedirection away from the loop, comprising a support formed of a pair ofelongate arms pivoted one on the other intermediate their ends toprovide a clamping portion at the forward end and a handle portion atthe rearward end for rocking movement of the arms about the pivotbetween open and clamping positions with the vessel to be tied grippedbetween the portions of the arm forming the clamping end portion when inclamping position, carriage means mounted on said support for lengthwisemovement relative to the support between a forward position rearwardlyof the clamping end portion of the support and to one side thereof and arearward position toward the handle portion of the support, the supportin the clamping end portion being formed with smooth and unobstructedsurfaces on the side adjacent to the carriage and in which the clampingend portion of the arm adjacent the carriage is formed with a passageextending therethrough from the forward edge to a point on the side ofthe carriage and spaced rearwardly of the end but forwardly of thecarriage when in the forward position, mean on the carriage forreleasably engaging the free end portion of the ligature when the loopedend portion of the ligature is positioned about the end portion of thesupport and the free end portion of the ligature is threaded through thepassage from the forward end to the rearward end releasably to beengaged by the carriage when in forward position whereby rearwarddisplacement of the carriage from forward position toward rearwardposition operates to effect forward displacement of the looped endportion for travel off of the clamping end portion of the support andabout the vessel being clamped, and means movably mounted on directionaway from the loop, comprising a support formed of a pair of elongatearms pivoted one on the other intermediate their ends to provide aclamping portion at the forward end and a handle portion at the rearwardend for rocking movement of the arms about the pivot between open andclamping positions with the vessel to be tied gripped between theportions of the arm forming the clamping end portion when in clampingposition, carriage means mounted on said support for lengthwise movementrelative to the support between a forward position rearwardly of theclamping end portion of the support and to one side thereof and arearward position toward the handle portion of the support, the supportin the clamping end portion being formed with smooth and unobstructedsurfaces on the side adjacent to the carriage and in which the clampingend portion of the arm adjacent the carriage is formed with a passageextending therethrough from the forward edge to a point on the side ofthe carriage and spaced rearwardly of the end but forwardly of thecarriage when in the forward position, means on the carriage forreleasably engaging the free end portion of the ligature when the loopedend portion of the ligature is positioned about the end portion of thesupport and the free end portion of the ligature is threaded through thepassage from the forward end to the rearward end releasably to beengaged by the carriage when in forward position whereby rearwarddisplacement of the carriage from forward position toward rearwardposition operates to effect forward displacement of the looped endportion for travel off of the clamping end portion of the support andabout the vessel being clamped, and a locating groove in an intermediateportion of the support for initially positioning the loop about theclamping end portion of the support.

13. An apparatus of the class described for use with a ligature having alooped end portion and a free end portion which operates to tighten theloop during relative endwise displacement of the free end portion in thedirection away from the loop, comprising a support formed of a pair ofelongate arms pivoted one on the other intermediate their ends toprovide a clamping portion at the forward end and a handle portion atthe rearward end for rocking movement of the arms about the pivotbetween open and clamping positions with the vessel to be tied grippedbetween the portions of the arm forming the clamping end portion when inclamping position, carriage means mounted on said support for lengthwisemovement relative to the support between a forward position rearward-1yof the clamping end portion of the support and to one side thereof and arearward position toward the handle portion of the support, the supportin the clamping end portion being formed with smooth and unobstructedsurfaces on the side adjacent to the carriage and in which the clampingend portion of the arm adjacent the carriage is formed with a passageextending therethrough from the forward edge to a point on the side ofthe carriage and spaced rearwardly of the end but forwardly of thecarriage when in the forward position, means on the carriage forreleasably engaging the free end portion of the ligature when the loopedend portion of the ligature is positioned about the end portion of thesupport and the free end portion of the ligature is threaded through thepassage from the forward end to the rearward end releasably to beengaged by the carriage when in forward position whereby rearwarddisplacement of the carriage from forward position toward rearwardposition operates to effect forward displacement of the looped endportion for travel off of the clamping end portion of the support andabout the vessel being clamped, and means for releasably holding thearms of the support in clamping position.

References Cited in the file of this patent UNITED STATES PATENTS1,625,602 Gould et al. Apr. 19, 1927 1,855,546 File Apr. 26, 19321,940,351 Howard Dec. 19, 1933

